Purpose
Incisional hernia (IH) occurs when there is a partial or complete solution of continuity of a fascia previously incised. Systematic reviews demonstrate that surgical treatment of IHs with the ...use of meshes are approximately 16%. Meta-analyses have demonstrated the superiority of mesh placement using sublay technique, but without a pathophysiological explanation. Thus, we aim to evaluate the different techniques of mesh positioning in an experimental model.
Methods
Fifty rats were distributed into five groups; control; simulation (SM)—submitted to laparotomy only; onlay—the mesh was positioned in onlay fashion; retromuscular (SL)—the mesh was positioned in a sublay fashion; intraperitoneal (IPOM)—positioning of the mesh adjacent to the transversalis fascia, inside the cavity. After 60 days, adhesions, tensiometry, histology, and immunohistochemistry were addressed.
Results
The IPOM group had the most adhesions, together with the SL group, with significantly relevant results. The SL group had higher values of tensiometric evaluation, while the IPOM group had the lowest mean in the tensiometry evaluation, being even lower than the SM group. Regarding histological and immunohistochemical findings, the SL group had a higher pixel number count compared to the groups, with statistical significance, in addition to higher expression of polymorphonuclear infiltrate and CD68 markers.
Conclusion
The mesh positioning in sublay compartment is associated with the development of more pronounce minimum tensile force required for detaching the surrounding abdominal wall tissues it was incorporated. The intensity of these findings correlates to the different histological and immunohistochemical profiles observed following each repair, since SL group was characterized by a higher proportion of collagen, inflammatory, and reparative elements. Characterizing these pro-healing elements and its counterparts will allow the development of new therapeutic tools which could be added to the still far-from-ideal current therapeutic options for IH treatment.
Purpose
To compare adhesion scores, repair strength and histological findings among sublay, onlay and primary repair incisional hernioplasty techniques. Surgical repairs were employed directly on ...healthy animals, without previous hernia induction, to avoid confounding factors related to hernia development.
Methods
Forty Wistar rats were divided into four groups, control, simulation, onlay and sublay. After 42 days, adhesion intensity, tensile strength of the abdominal wall and anatomopathological histological substrate were compared.
Results
SL group presented greater adhesion scores (
p
< 0.0001), higher tensiometric (
p
< 0.0001), and was characterized by more histiocytes, mononuclear cells, macrovacuolar granulomas and type I collagen on histological analysis. Pearson correlation between adhesions and tensiometry, and between tensiometry and neocollagenization showed a strong positive association (
r
= 0.8905 and 0.6757, respectively in SL group,
p
< 0.05).
Conclusion
Mesh positioning in sublay compartment was followed by increased adhesion development and provides a stronger mesh–tissue attachment, in addition, resulted in a different histological profile of the inflammation/repair substrate. The intensity of these findings was directly correlated, suggesting they could be the result of a common biological phenomenon. Our findings indicate that mesh placement following the retromuscular technique generates a superior repair response, and give clues to a better understanding of the superiority of sublay repair in achieving lower recurrence rates. Characterization of the cellular and molecular elements responsible for the superiority of this technique is in our view an essential prerequisite aiming for improvements in the therapeutic options for the treatment of this disease.
Equestrian sports require precise animal welfare and health evaluations. To test the hypothesis that horses maintain their welfare when subjected to two three-barrel (3TB) races with 2 min intervals, ...an experiment was designed to evaluate their surface temperature using infrared thermography (IRT) in regions of interest (barrel, flank, neck, jaw, corner of the mouth, and ocular caruncle) and also measure blood biomarkers (hemogram, total plasma protein, fibrinogen, urea, creatinine, GGT, CK, cortisol, IL-6, and IL-1β). Ten Quarter Horses were monitored through thermography (pre-race, +1, +4, and +24 h post-race) and blood sampling (pre-race, +1, +4, and +24 h post-race). ANOVA and Tukey test at 5% were used. IRT in six regions of interest (Left/Right-barrel, flank, neck muscles) increased at +, with no differences between values recorded at +1 and +4 when compared to those measured pre-race (
> 0.05). Plasma protein, RBC count, hemoglobin, hematocrit, WBC count, neutrophils, and lymphocytes (
< 0.05) increased immediately after the races, with recovery at +1 h. Other biomarkers did not change, including cortisol, IL-6, and IL-1β (
> 0.05). Results indicate that well-conditioned 3TB horses subjected to two races at short intervals do not show changes that could be related to impaired health or welfare.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Necrosectomy is the gold standard treatment for infected pancreatic necrosis (IPN). A percutaneous and endoscopic approach has been accepted in selected cases. Endoscopic drainage (ED) of IPN can be ...performed by using transpapillary or transmural procedures, or a combination of both with or without endoscopic ultrasound.
The aim of this study was to determine the indications, complications, success rate, and the importance of assessment of main pancreatic duct integrity by endoscopic retrograde pancreatography (ERP) in patients with IPN.
Records of all patients who underwent endoscopic necrosectomy from January 2002 to December 2007 at Rio de Janeiro Federal University Hospital were reviewed. A total of 56 patients were included. ED was performed using daily transmural and transpapillary drainage. A diagnostic pancreatogram (ERP) to search for communications between the pancreatic duct and the collection were performed in all cases and in cases where communication existed. A pre-cut needle knife was used to puncture the cyst wall, aspirate the content and then enter at the cyst cavity (contrast was injected to ensure opacification of the cyst and subsequent drainage). Sphincterotomy catheter or balloons were used to enlarge and ensure a wide cystoenterostomy. All patients were followed with computerized tomography scans or ultrasound to ensure clinical resolution. Mean follow-up was 21 months.
49/56 patients could be successfully treated. ED was successful in 49 patients (87%) and in 3 (13%) it failed. Mean follow-up was 21 months. During this period, there were 2 (10.5%) pseudocyst recurrences and only 1 (5.2%) recurrence of new episodes of pancreatic necrosis, and all were managed clinically and/or endoscopically. No mortality was related to the procedure.
ED with daily necrosectomy is a useful method to remove infected and sterile pancreatic necrosis.
Complex inguinal hernia repairs Beitler, J. C.; Gomes, S. M.; Coelho, A. C. J. ...
Hernia : the journal of hernias and abdominal wall surgery,
02/2009, Letnik:
13, Številka:
1
Journal Article
Recenzirano
Introduction
Complex inguinal hernia treatment is a challenge for general surgeons. The gold standard for the repair of inguinal hernias is the Lichtenstein repair (anterior approach). However, when ...multiple recurrent hernias or giant hernias are present, it is necessary to choose different approaches because the incidence of poor results increases. There are many preperitoneal approaches described in the literature. For example: (a) open procedure—Nyhus and Stoppa (b) laparoscopic technique—transabdominal pre-peritoneal (TAPP) and totally extraperitoneal (TEP). In this study, we show how we repair complicated cases using open access in huge unilateral or bilateral, recurrent, or multiple recurrent inguinal hernias.
Methods
The present study includes the period from November 1993 through December 2007. One hundred and eighty-eight patients, divided into 121 with unilateral hernias and 67 with bilateral hernias, totaling 255 inguinal hernia repairs, were treated by the Nyhus or Stoppa preperitoneal approach, depending on whether they were unilateral or bilateral. We used progressive preoperative pneumoperitoneum for oversize inguinal hernias in all patients.
Results
Orchiectomy was necessary on only two occasions. Despite the repair complexity involved, we had only two known recurrences. The mortality was zero and the morbidity was acceptable.
Conclusions
We conclude that an accurate open preperitoneal approach using mesh prosthesis for complex inguinal hernias is safe, with very low recurrent rates and low morbidity. Progressive preoperative pneumoperitoneum for giant hernias was shown to be an important factor in accomplishing good intraoperative and immediate postoperative results.
This paper presents experimental work on the characteristics of jets issuing from water-releasing structures. Systematic experimental tests have been performed at near-prototype velocities of up to ...30 m/s using a cylindrical jet nozzle. Dynamic pressures were measured along the diameter at the nozzle outlet with an acquisition rate of up to 2 kHz, for different upstream supply conditions. These measurements allowed assessing the mean and the fluctuating characteristics of the jet. The influence of supply circuit secondary currents, aeration and geometrical contraction on jet turbulence intensity and velocity profiles is discussed. The initial turbulence intensity varies from 2 to 8%, whereas the kinetic energy correction factor ranges from 1.0 to 1.1. Statistical analysis of pressure measurements shows that jet core pressures follow a Gaussian distribution fairly well for non-exceedence probabilities between 0.1 and 0.999. The experimental results and an extensive literature survey are used to define issuance parameters relevant for engineering practice.
Dynamic pressures created by the impact of high-velocity turbulent jets plunging in a water pool with flat bottom were investigated. Pressure fluctuations were sampled at 1 kHz at the jet outlet and ...at the pool bottom using piezo-resistive pressure transducers, jet velocities of up to 30 m/s and pool depth to jet diameter ratios from 2.8 to 11.4. The high-velocity jets entrain air in the pool in conditions similar to prototype applications at water release structures of dams. The intermittent character of plunge pool flows was investigated for shallow and deep pools, based on high order moments and time correlations. Maximum intermittency was observed for pool depths at 5.6 jet diameters, which approximate the core development length. Wall pressure skewness was shown to allow identifying the zone of influence of downward and upward moving currents.
Purpose
To evaluate the efficacy and safety of first-line therapy with palbociclib in a Spanish cohort treated after palbociclib approval.
Methods
PALBOSPAIN is an observational, retrospective, ...multicenter study evaluating real-world patterns and outcomes with 1 L palbociclib in men and women (any menopausal status) with advanced HR
+
/HER2– BC diagnosed between November 2017 and November 2019. The primary endpoint was real-world progression-free survival (rw-PFS). Secondary endpoints included overall survival (OS), the real-world response rate (rw-RR), the clinical benefit rate, palbociclib dose reduction, and safety.
Results
A total of 762 patients were included. The median rw-PFS and OS were 24 months (95% CI 21–27) and 42 months (40-not estimable NE) in the whole population, respectively. By cohort, the median rw-PFS and OS were as follows: 28 (95% CI 23–39) and 44 (95% CI 38-NE) months in patients with
de novo
metastatic disease, 13 (95% CI 11–17) and 36 months (95% CI 31–41) in patients who experienced relapse < 12 months after the end of ET, and 31 months (95% CI 26–37) and not reached (NR) in patients who experienced relapse > 12 months after the end of ET. rw-PFS and OS were longer in patients with oligometastasis and only one metastatic site and those with non-visceral disease. The most frequent hematologic toxicity was neutropenia (72%; grade ≥ 3: 52.5%), and the most common non-hematologic adverse event was asthenia (38%).
Conclusion
These findings, consistent with those from clinical trials, support use of palbociclib plus ET as 1 L for advanced BC in the real-world setting, including pre-menopausal women and men.
Trial registration number
NCT04874025 (PALBOSPAIN). Date of registration: 04/30/2021 retrospectively registered.
1 CIRAD, UMR 15 Control of Exotic and Emerging Animal Diseases, TA A-15/G, Campus International Baillarguet, 34398 Montpellier Cedex 5, France
2 Institute of Veterinary Bacteriology, University of ...Bern, Vetsuisse Faculty, Länggass-Str. 122, PO Box, CH-3001 Bern, Switzerland
3 Friedrich-Loeffler-Institut (Federal Research Institute for Animal Health), Naumburger Str. 96a, D-07743 Jena, Germany
4 NSW Department of Primary Industries, Elizabeth Macarthur Agricultural Institute, PMB 8, Camden, NSW, Australia
5 Institute for the Biotechnology of Infectious Diseases, University of Technology Sydney, Level 6, Building 4, Cnr Thomas and Harris St, Ultimo, Sydney, NSW 2007, Australia
Correspondence L. Manso-Silván lucia.manso-silvan{at}cirad.fr
The Mycoplasma mycoides cluster consists of six pathogenic mycoplasmas causing disease in ruminants, which share many genotypic and phenotypic traits. The M. mycoides cluster comprises five recognized taxa: Mycoplasma mycoides subsp. mycoides Small Colony (MmmSC), M. mycoides subsp. mycoides Large Colony (MmmLC), M. mycoides subsp. capri (Mmc), Mycoplasma capricolum subsp. capricolum (Mcc) and M. capricolum subsp. capripneumoniae (Mccp). The group of strains known as Mycoplasma sp. bovine group 7 of Leach (MBG7) has remained unassigned, due to conflicting data obtained by different classification methods. In the present paper, all available data, including recent phylogenetic analyses, have been reviewed, resulting in a proposal for an emended taxonomy of this cluster: (i) the MBG7 strains, although related phylogenetically to M. capricolum , hold sufficient characteristic traits to be assigned as a separate species, i.e. Mycoplasma leachii sp. nov. (type strain, PG50 T = N29 T = NCTC 10133 T = DSM 21131 T ); (ii) MmmLC and Mmc, which can only be distinguished by serological methods and are related more distantly to MmmSC, should be combined into a single subspecies, i.e. Mycoplasma mycoides subsp. capri , leaving M. mycoides subsp. mycoides (MmmSC) as the exclusive designation for the agent of contagious bovine pleuropneumonia. A taxonomic description of M. leachii sp. nov. and emended descriptions of M. mycoides subsp. mycoides and M. mycoides subsp. capri are presented. As a result of these emendments, the M. mycoides cluster will hereafter be composed of five taxa comprising three subclusters, which correspond to the M. mycoides subspecies, the M. capricolum subspecies and the novel species M. leachii .
Abbreviations: CBPP, contagious bovine pleuropneumonia; CCPP, contagious caprine pleuropneumonia; DDH, DNA–DNA hybridization; MBG7, Mycoplasma sp. bovine group 7 of Leach; Mcc, Mycoplasma capricolum subsp. capricolum ; Mccp, Mycoplasma capricolum subsp. capripneumoniae ; Mmc, Mycoplasma mycoides subsp. capri ; MmmLC, Mycoplasma mycoides subsp. mycoides Large Colony; MmmSC, Mycoplasma mycoides subsp. mycoides Small Colony
Erosions and gastric ulcers may be present in horses at any age and under different conditions of rearing and handling. In tropical regions, horses can feed on fruits rich in soluble carbohydrates, ...such as mangoes, but little is known about how these foods interact with their digestive systems. To test the hypothesis that the ingestion of ripe mangoes with peels could cause disturbances in the digestive processes of horses, an experiment was developed to monitor animals that had free access to ripe mangoes in their pasture areas. Horses (purebred Arabians, n = 5; ~340 kg, ~13 years) were evaluated by video gastroscopy and blood analysis. A controlled postprandial glucose curve for mango intake was also performed. Gastroscopies were performed at intervals of 15 days, starting in December, just before the beginning of the harvest, until the beginning of February, and days after the end of the harvest. Blood collection was performed on the same day between November and February for blood analysis. The results were submitted to ANOVA and Tukey’s test, with a significance level of p < 0.05. Gastroscopies indicated that four out of five horses had erosions and ulcers in the squamous region between 15 and 30 days after the start of the season. Biochemical tests indicated a reduction in plasma proteins during the harvest period, and the postprandial glucose curve showed concentrations above 200 mg/dL between 30 and 180 min after ingestion of 5.37 kg mangoes. The animals were not treated and recovered after 15 days of harvest and without ripe mangoes on the ground. It is concluded that the indiscriminate ingestion of mangoes favors the appearance of lesions in the gastric squamous region, to varying degrees, and that animals recover naturally after an average of 15 days from the end of the season when the animals return to their regular feeding with hay and grass pasture.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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